CN102470008A

CN102470008A - Medical apparatus and surgical treatment instrument

Info

Publication number: CN102470008A
Application number: CN2010800268706A
Authority: CN
Inventors: 佐内秀男; 大沼龙
Original assignee: Olympus Medical Systems Corp
Current assignee: Olympus Corp
Priority date: 2010-03-31
Filing date: 2010-10-15
Publication date: 2012-05-23
Anticipated expiration: 2030-10-15
Also published as: US8696666B2; WO2011121827A1; EP2425790A1; EP2425790B1; EP2425790A4; US20110288451A1; JP4856290B2; JPWO2011121827A1; CN102470008B

Abstract

A medical apparatus has a first device, a second device, a cable, a connection signal output portion and a main body apparatus. The first device includes a grasping portion, a probe connected to the grasping portion and capable of transmitting at least one of an ultrasound vibration and a high-frequency current, and a treatment portion provided at a distal end portion of the probe and for transmitting at least one of the ultrasound vibration and the high-frequency current transmitted by the probe, to living tissue. A second device includes a jaw member for holding living tissue between the treatment portion and the jaw member, a movable handle for holding the living tissue by moving the jaw member toward the treatment portion, and a recessed portion for being attachably and detachably engaged with the first device. The connection signal output portion outputs a connection signal indicating that the first device is connected to the recessed portion of the second device. The main body apparatus controls output of a drive signal for supplying at least one of an ultrasound vibration and a high-frequency current to the first device.

Description

Medical treatment device and surgical instrument

Technical field

The present invention relates to medical treatment device and surgical instrument, particularly relate to can output ultrasonic wave at least one medical treatment device and surgical instrument in vibration and the high frequency electric.

Background technology

Surgical instrument be used for operation carry out bio-tissue incision, processing such as solidify.Orthopaedic surgical operations is with in the preparation implement; According to the shape of handling part, have the surgical instrument (so-called shears shape type) of the type that clamping handles bio-tissue and the surgical instrument (for example hook shape or cochlear shape type) of the type that contacts the processing bio-tissue.In addition, orthopaedic surgical operations is with in the preparation implement, and known have the ultrasonic Treatment utensil that for example can carry out ultrasound wave output and can carry out the high-frequency treatment instrument that high frequency electric is exported.

For example; In the ultrasonic Treatment utensil of shears shape type, a member carries out ultrasonic vibration, and another jaw member opens and closes with respect to a member in order to carry out clamping; In the ultrasonic Treatment utensil of cochlear shape type, the top is that a probe of cochlear shape carries out ultrasonic vibration.In addition, in the high-frequency treatment instrument of shears shape type, use two members to carry out the bipolar output of high frequency electric, in the high-frequency treatment instrument of cochlear shape type, use the top to be one of cochlear shape probe and pole plate, carry out one pole output.

In addition, for example in TOHKEMY 2009-78155 communique, a kind of the two pliers of bipolar output and one pole output that in high-frequency treatment instrument, can carry out has been proposed.

But when operation, the preparation implement that operator is selected to be suitable for handling is handled.In operation process, also often change the preparation implement that is suitable for handling.For example being replaced by under peritoneoscope of this preparation implement is replaced by the ultrasonic Treatment utensil of cochlear shape with the ultrasonic Treatment utensil of shears shape or the high-frequency treatment instrument of shears shape is replaced by the high-frequency treatment instrument of cochlear shape.

When the operator right-hand man grips different preparation implements respectively; Mostly the replacing of preparation implement is that operator waits indication to change to the nurse; Pass nurse etc. with the preparation implement that uses, the ultrasonic Treatment utensil of for example shears shape always, wait from the nurse and take over the preparation implement that next uses, the ultrasonic Treatment utensil of for example cochlear shape.

At this moment, the preparation implement that nurse etc. will pass is unloaded down from the control device corresponding with it, and the preparation implement that next operator is used is connected on the control device corresponding with it, after being set to the state that can use, passs operator.

But the replacing time of preparation implement is short more good more in the operation process, and this is because alleviate the burden to the patient.Operator waited and send indication, will use always preparation implement from this moment to nurse is passed nurse etc., nurse etc. and is carried out unloading from control device operation such as preparation implement, passs this above-mentioned a succession of operation of preparation implement that next operator use and have not only complicacy but also the such problem of spended time.

In addition, the high-frequency treatment instrument that proposed of above-mentioned TOHKEMY 2009-78155 communique is the pliers of the structure of top ends with member in two members of the bipolar pliers elongated portion that is provided with unipolar component.Adopt this high-frequency treatment instrument, operator need not to prepare in advance respectively one pole preparation implement and bipolar preparation implement, just can utilize a preparation implement to carry out the processing of one pole output and bipolar output.

But; The high-frequency treatment instrument of this motion is used for owing to the top ends at bipolar pliers has and can extends the structure of unipolar component on the member at two members, so exists the size and the shape of a member maximization and complicated and unipolar component to be restricted such problem.The restriction of size of the maximization of top ends, complicated and unipolar component etc. causes operator to feel the ease of use variation of preparation implement.In addition, because the restriction of the maximization of top ends and the size of unipolar component etc., under peritoneoscope, the visual field of operator is possible deviation also.

Summary of the invention

The object of the present invention is to provide and on a preparation implement, can easily change surgical instrument and the medical treatment device and the surgical instrument of the surgical instrument of the type that contacts the processing bio-tissue that the type of bio-tissue is handled in clamping.

One aspect of the invention is, a kind of medical treatment device comprises the 1st assembly, the 2nd assembly, connects signal efferent and control part, and above-mentioned the 1st assembly comprises: handle part; Probe, it is connected with this handle part, and can transmit in ultrasonic vibration and the high frequency electric at least one; And the 1st handling part, it is arranged on the top ends of above-mentioned probe, and at least one of above-mentioned ultrasonic vibration that is used for being transmitted by above-mentioned probe to the bio-tissue transmission and high frequency electric; Above-mentioned the 2nd assembly comprises: the 2nd handling part, and it is used for clamping bio-tissue between the 2nd handling part and above-mentioned the 1st handling part; But fixed handle, it is used to make above-mentioned the 2nd handling part to come the above-mentioned bio-tissue of clamping near above-mentioned the 1st handling part; And the handling part, it is used for cooperating with above-mentioned the 1st assembly with the mode that can load and unload freely; Above-mentioned connection signal efferent is used for output and connects signal; This connection signal indication is connected with above-mentioned the 1st assembly on the above-mentioned handling part of above-mentioned the 2nd assembly; Above-mentioned control part is used to control the output that drives signal, and this driving signal is used for supplying with at least one of above-mentioned ultrasonic vibration and high frequency electric to above-mentioned the 1st assembly.

Another aspect of the present invention is that a kind of surgical instrument comprises: handle part; Probe, it is connected with this handle part, and can transmit in ultrasonic vibration and the high frequency electric at least one; And the 1st handling part, it is arranged on the top ends of this probe, and at least one of above-mentioned ultrasonic vibration that is used for being transmitted by above-mentioned probe to the bio-tissue transmission and high frequency electric; Above-mentioned surgical instrument has can export the connection signal efferent that connects signal; This connection signal indication is connected with the situation of the assembly with the 2nd handling part on being installed in above-mentioned surgical instrument the time, and the 2nd into treatment sites is in the position relative with the top ends of above-mentioned probe.

Description of drawings

Fig. 1 is the figure of structure of the surgery systems of expression embodiment of the present invention.

Fig. 2 is the front view of structure of the handpiece 2 of this embodiment of expression.

Fig. 3 is that expression has separated two assemblies constituting handpiece 2, the i.e. figure of the state of the 1st assembly 11 and the 2nd assembly 12.

Fig. 4 is the cutaway view of the 1st assembly 11.

Fig. 5 is the cutaway view of the handle part 22 of the 1st assembly 11.

Fig. 6 is the profile along the VI-VI line of Fig. 5.

Fig. 7 is the profile along the VII-VII line of Fig. 5.

Fig. 8 is the profile along the VIII-VIII line of Fig. 5.

Fig. 9 is the profile along the IX-IX line of Fig. 5.

Figure 10 is the cutaway view when to overlook top ends be the probe 21A of hook shape.

Figure 11 is the front view of the plug 151 in the connector portion 23.

Figure 12 is the front view of the socket 161 in the connector portion 3a.

Figure 13 be used to explain plug 151 and socket 161 be connected, along the profile of the XIII-XIII line of Figure 11 and Figure 12.

Figure 14 is the cutaway view of the 2nd assembly 12.

Figure 15 is the front view of variation of the 2nd assembly of this embodiment.

But Figure 16 is the figure that is used to explain the variation when being provided with switch in the position of the confession fixed handle butt of the 1st assembly.

Figure 17 is the cutaway view that is used to explain the structure of switch 36A.

Figure 18 is the cutaway view that is used to explain the structure of switch 36A.

Figure 19 is the cutaway view of the variation of expression switch 36A.

Figure 20 is handling part 21a and jaw member 31 profile along the XX-XX line of Fig. 2.

Figure 21 is the figure that is used to explain the structure of the handling part under the situation of probe 21A of hook shape.

Figure 22 is the block diagram of the structure of expression agent set 3.

The specific embodiment

(overall structure)

Fig. 1 is the figure of structure of the surgery systems of expression embodiment of the present invention.Comprise handpiece 2, agent set 3, foot switch 4 and pole plate 5 as the surgery systems 1 of medical treatment device as output-controlling device.

Handpiece 2 is to carry out the two surgical instrument of ultrasound wave output and high frequency electric output.Handpiece 2 is connected with agent set 3 via the cable 2a that can load and unload.Handpiece 2 has insertion section 2b and handle portion 2c.

Agent set 3 as control part is supplied with at least one that is used for ultrasound wave driving signal of exporting and the driving signal that is used for high frequency electric output according to setting.Particularly, agent set 3 have three output modes, output mode when being ultrasound wave output mode, high frequency output mode and ultrasound wave and high frequency.The output mode utilization is arranged on various action button 3c on the agent set 3 etc. and sets.In addition, agent set 3 is built-in with the speaker (not shown) that is used for output sound or sound.

Agent set 3 has a plurality of display 3b and a plurality of various action button 3c.Display 3b is used for display setting value etc., and various action button 3c are the buttons that are used to carry out the setting etc. of various outputs.

Foot switch 4 is connected with agent set 3 via cable 4a, if switch 4 is stepped in the operator step that tramps with one's feet, and the predetermined operation signal F S of output and supply with then to agent set 3.Foot switch 4 is the switch that is used to open or close ultrasound wave output when ultrasound wave is exported, and is the switch that is used to open or close high frequency output when high frequency is exported.The action button of the guidance panel through operating main body device 3 is set the output valve of ultrasonic vibration and high frequency electric.

Pole plate 5 is connected with agent set 3 via cable 5a.Pole plate 5 is the return electrode that is used for making the electric current that circulates at subject to return when bipolar output high frequency electric.

Operator can enough held handpieces 2, for example under peritoneoscope, undergo surgery with other preparation implements of another held.

(structure of handpiece)

Fig. 2 and Fig. 3 are the figure of structure of the handpiece 2 of this embodiment of expression.Fig. 2 is the front view of structure of the handpiece 2 of this embodiment of expression.Fig. 3 is that expression has separated two assemblies constituting handpiece 2, the i.e. figure of the state of the 1st assembly 11 and the 2nd assembly 12.As shown in Figure 3, handpiece 2 constitutes through the 1st assembly 11 is installed on the 2nd assembly 12.

As shown in Figure 3, the 1st assembly 11 is following a kind of surgical instruments: it comprises the probe 21 that can transmit ultrasonic vibration, be arranged on the roughly columned handle part 22 of the base end side of probe 21, be arranged on cable 2a and the connector portion 23 that is arranged on the base end part of cable 2a of the base end side of handle part 22.

Probe 21 is connected with handle part 22, is at least one the shaft component of electric conductivity that can transmit in ultrasonic vibration and the high frequency electric.The top ends of probe 21 is the handling part 21a with cochlear shape.Handling part 21a is located at probe 21 top ends, is at least one part of ultrasonic vibration from probe to the bio-tissue transmission that be used for being transmitted by and high frequency electric.Near insulating sheath 24 is arranged to the top ends of probe 21 with the mode of the peripheral part that covers probe 21 from the top ends of handle part 22.But the top ends of probe 21 is outstanding from the top end opening of insulating sheath 24.That is, insulating sheath 24 covers the part except that the handling part 21a of top ends of probe 21.Connector portion 23 constitutes and can load and unload freely with respect to the connector portion 3a of agent set 3.When connector portion 23 was connected on the connector portion 3a, the plugs in the agent set 3 matched with the socket of connector portion 3a.The structure of illustrated later plug and socket.

The 1st assembly 11 has the stage portion 25 that is provided with a plurality of electric contact points between handle part 22 and insulating sheath 24.Stage portion 25 is made up of a plurality of columned stage portion that the mode of going staged to dwindle from handle part 22 towards the top of insulating sheath 24 with diameter forms.Stage portion 25 becomes the shape that can cooperate with the recess 41 of the 2nd assembly, so that the 1st assembly 11 can be installed on the 2nd assembly 12.Thereby the recess 41 of the 2nd assembly 12 is provided with a plurality of stage portion in interior perimembranous, so that cooperate with stage portion 25.That is, recess 41 formation handling parts, this handling part are used for the 1st assembly 11 is cooperated with the mode that can load and unload with the 2nd assembly 12.

In addition, as after state, the 1st assembly 11 also is the surgical instrument exported when can independently carry out ultrasound wave output, high frequency output and ultrasound wave and high frequency, is handpiece.The more detailed structure of illustrated later the 1st assembly 11.

The 2nd assembly 12 be included in top ends be provided with moveable jaws 31 insertion section 2b, be arranged on insertion section 2b base end side operating portion main body 32 and be arranged on the handle portion 2c on the operating portion main body 32.

Insertion section 2b is insulated the tubular element that conductive material that layer covers constitutes by outer peripheral face, has by 1 supporting of pin 2b and is supported to that can to sell 2b 1 with this be center rotation moveable jaws 31 freely in top ends.The rear end of moveable jaws 31 is connected with driving shaft (not shown).As after state, moveable jaws 31 can open and close along the above-below direction among Fig. 2 and Fig. 3 by this driving shaft (not shown) according to the operation of handle portion 2c.

The base end side of 2b is provided with and is used to make the turning knob 33 of insertion section 2b around its axis rotation in the insertion section.Rotary knob 33 is fixed on the periphery of base end part of insertion section 2b.On the other hand, rotary knob 33 is not fixed on the operating portion main body 32, but being connected with respect to the mode and the operating portion main body 32 of operating portion main body 32 rotations.Thereby, through making rotary knob 33 rotations, can make rotary knob 33 and insertion section 2b length-wise axis rotation with respect to operating portion main body 32 2b around the insertion section.Operator rotates the axis of turning knob 33 2b around the insertion section, can be any direction with the switching direction setting of moveable jaws 31.

But handle portion 2c comprises fixed handle 34 and fixed handle 35.Fixed handle 34 forms as one with operating portion main body 32, and what have a plurality of finger lodges except that thumb that supply operator takes finger-hole 34a.But fixed handle 35 is to be that rotate freely at the center with the pin 32a that is arranged on the operating portion main body 32 by the axle supporting.What but fixed handle 35 had the thumb lodge that supplies operator takes finger-hole 35a.

But near the position the pin 32a of fixed handle 35 is connected with the base end part of the driving shaft (not shown) that is connected with the rear end of moveable jaws 31.But constituting, the 2nd assembly 12 make fixed handle 35 near 34 moveable jaws 31 closures of fixed handle.That is, but be that the fulcrum post 2b 1 that the motion of center of rotation converts into moveable jaws 31 is the motion of center of rotation with the pin 32a of fixed handle 35.In Fig. 2, dot the state of moveable jaws 31 closures, represent moveable jaws 31 open states with solid line.

That is, moveable jaws 31 is the handling parts that are used for clamping bio-tissue between itself and handling part 21a, but fixed handle 35 is that to be used to make handling part be moveable jaws 31 is come the clamping bio-tissue near handling part 21a operating portion.

In addition, on operating portion main body 32, be provided with two shift knobs 36,37.Shift knob 36 is switches of opening and cutting out usefulness of ultrasound wave output or high frequency electric output.Switch 37 is the switches that are used to change the output valve of ultrasound wave or high frequency.The operation signal HS of the

shift knob

36,37 of operating portion main body 32 supplies with to agent set 3 via contact 201b, 117b, conducting member 188, the holding wire 2ab of correspondence.

In addition,

shift knob

36,37 also can be used as the switch that only carries out high frequency output and plays a role, and utilizes foot switch 4 to impel and carries out ultrasound wave output.

And; Opening and closing and the change of output valve about ultrasound wave output or high frequency electric output; Not only can utilize two switches of operating portion main body 32 to carry out, also can utilize the various switch 3c of agent set 3 to carry out, about the setting of output mode etc.; Not only can utilize the various switch 3c of agent set 3 to carry out, also can utilize two switches of operating portion main body 32 to carry out.

Base end side in the operating portion main body 32 of the 2nd assembly 12 is formed with the recess 41 as the handling part, and this recess 41 is used for cooperating with the 1st assembly 11 with the mode that can load and unload freely.The 2nd assembly 12 has penetrating via 42, through the top of the probe 21 of the 1st assembly 11 is inserted and can be made insulating sheath 24 run through this penetrating via 42 from recess 41.Recess 41 is forming with the mode that the stage portion 25 of the 1st assembly 11 cooperates.If so that the mode that stage portion 25 cooperates with recess 41 is installed in the 1st assembly 11 on the 2nd assembly 12; Then the 1st assembly 11 and the 2nd assembly 12 are connected; The handling part 21a of the top ends of the probe 21 of the 1st assembly 11 is outstanding from the insertion section 2b of the 2nd assembly 12, carrying out holding action with the moveable jaws 31 of the 2nd assembly.If the 1st assembly 11 and the 2nd assembly 12 are connected; Then utilize the top ends of probe 21 to form the handling part that can carry out clamping, be arranged on a plurality of electric contact points and a plurality of electric contact points on being arranged on recess 41 on the stage portion 25 and be mutual corresponding contact and contact each other and be electrically connected with moveable jaws 31.Illustrated later is electrically connected.

Therefore, operator is installed in the 2nd assembly 12 on the 1st assembly 11 in operation process, and uses the handpiece 2 of shears shape to handle, and afterwards, extracts handpiece 2 trocar from the body wall that is arranged on subject (trocar) out.Operator unloads the 2nd assembly 12 from the 1st assembly 11, and the 1st assembly 11 is inserted in the trocars, then can use the 1st assembly 11 of cochlear shape to handle as handpiece.In addition; Otherwise; After the 1st assembly 11 that uses the cochlear shape is handled; Extract the 1st assembly 11 trocar of operator from the body wall that is arranged on subject out and the 2nd assembly 12 is installed, the 1st assembly 11 that the 2nd assembly 12 is installed is inserted in the trocar, then can use the handpiece 2 of shears shape to handle.

At this moment, as after state, be used in agent set 3, to detect the 2nd assembly 12 and be installed in the situation on the 1st assembly 11 from the connection signal DS of the 1st assembly 11.

Therefore; According to this testing result, for example be used as at the preparation implement that is connected under the situation of high-frequency treatment instrument of shears shape, agent set 3 carries out bipolar output; Be used as at the preparation implement that is connected under the situation of high-frequency treatment instrument of cochlear shape, agent set 3 carries out one pole output.In addition, agent set 3 changes output valve according to testing result between the situation of the ultrasonic Treatment utensil of the situation of the ultrasonic Treatment utensil of shears shape and cochlear shape.

(the 1st assembly)

Specify the structure of the 1st assembly 11.

Fig. 4 is the cutaway view of the 1st assembly 11.Fig. 4 be for 21 the top ends of representing to pop one's head in be the cutaway view that the situation of cochlear shape is overlooked.Fig. 5 is the cutaway view of the handle part 22 of the 1st assembly 11.The handling part 21a of the top ends of probe 21 is roughly straight in Fig. 2 and Fig. 3, but because Fig. 4 is the cutaway view of overlooking, so top ends bends to the cochlear shape in Fig. 4.Fig. 6 to Fig. 9 is the profile of handle part 22.Fig. 4 and Fig. 5 are the profiles along the A-A line of Fig. 6 to Fig. 9.Fig. 6 is the profile along the VI-VI line of Fig. 5.Fig. 7 is the profile along the VII-VII line of Fig. 5.Fig. 8 is the profile along the VIII-VIII line of Fig. 5.Fig. 9 is the profile along the IX-IX line of Fig. 5.

As above-mentioned, the 1st assembly 11 also is the surgical instrument that can use as handpiece separately.Handle part 22 is built-in with ultrasonic oscillator unit 101.Ultrasonic oscillator unit 101 has vibrating mass, this vibrating mass be by a plurality of form that cyclic piezoelectric element 102 clips circular a plurality of electrodes 103 of being configured between the adjacent piezoelectric element and range upon range of constitute cylindric.And; Be penetrated with bolt 104 in the through hole at range upon range of a plurality of piezoelectric elements 102 and the center of a plurality of electrodes 103; Be screwed into bolt 104 with respect to horn portion 105, thereby make a plurality of piezoelectric elements 102 and a plurality of electrodes 103 fluid-tight engagement securely, and constituted ultrasonic oscillator unit 101.This ultrasonic oscillator unit 101 is ten thousand bright type bolted ultrasonic oscillator unit.

Ultrasonic oscillator unit 101 is configured in the housing 111 cylindraceous.A plurality of holding wires of a plurality of electrodes 103 are connected via the part of a plurality of holding wire 2ab in the adapter 112 of the base end part of housing 111 and the cable 2a.And the tip side of horn portion 105 is probes 21, and the part 105a from horn portion 105 to probe constitutes the position of high frequency output.

As shown in Figure 5, be formed with flange part 105a at the base end part of horn portion 105.In addition, be formed with flange part 111a inwardly in the precalculated position in interior week of housing 111.On the inner peripheral surface of the top ends of housing 111, be formed with internal thread part 111b.

For example, after the holding wire with a plurality of electrodes 103 is connected on the adapter 112, insert ultrasonic oscillator unit 101 from the tip side of housing 111.The 111a of flange part inwardly of the flange part 105a of horn portion 105 and housing 111 connects.At flange part 105a and under the state that flange part 111a connects, utilize fixed component 113 cylindraceous that horn portion 105 is fixed on the housing 111 inwardly.Particularly, on the peripheral part of fixed component 113, form external thread part 113a, through this external thread part 113a is screwed in the internal thread part 111b of housing 111, and make the tip side pushing horn portion 105 of fixed component 113 from housing 111.Thus, in housing 111 internal fixation horn portions 105.In addition, between the base end part of fixed component 113 and flange part 105a, be provided with the sealing member 114 that constitutes by elastomeric material.And, on the peripheral part of fixed component 113, be provided with O type ring 115.Utilize sealing member 114 and O type ring 115 anti-sealings, blood etc. to get in the housing 111.

The tip side of housing 111 be equipped with tubular the lid member, be top end cover 116.On the inner peripheral surface of top end cover 116, be provided with O type ring 116a with mode with horn portion 105 fluid-tight engagement.

The tip side of top end cover 116 constitutes stage portion 25, on this stage portion 25, is provided with a plurality of electric contact points 117.On three stage portion of the outer peripheral face of top end cover 116, be respectively equipped with three contact 117a, 117b, 117c, on inner peripheral surface, be provided with a contact 117d.Particularly; On the periphery of stage portion 25, the joint detection that is provided with the holding wire that is connected with the connection that is used to detect the 2nd assembly 12 from the tip side of top end cover 116 is successively used contact 117c with contact 117a, the position that is connected with holding wire that position is used with contact 117b and the common line that is connected with holding wire that the common line of switching signal is used.And, on the inner peripheral surface of top end cover 116, be provided with exhausting line and use contact 117d.Contact 117d exposes on the surface of the inner peripheral surface of top end cover 116, as after state, contact 117d is arranged on the inboard of stage portion 25, can contact for the conductive member of the 2nd assembly 12.

If contact 117a with after the corresponding contact of the 2nd assembly 12 stated contact, then agent set 3 detects the 2nd assembly 12 and has been installed on the 1st assembly 11.Contact 117a is made up of two contacts, if with after the contact 201a of the 2nd assembly 12 sides stated contact, then between two contacts, form and conduct.Agent set 3 detects this conducting state.That is, contact 117a constitutes with holding wire 2ab can export the connection signal efferent that is connected signal DS, and this connection signal DS representes that the 2nd assembly 12 is connected on the 1st assembly 11.Connect signal DS according to this; Agent set 3 is changed into bipolar output with high frequency output from one pole output under the situation of high frequency output, the ultrasound wave output valve when the ultrasound wave output valve when exporting ultrasound wave from the cochlear shape under the situation of ultrasound wave output is changed into the shears shape.

Three contact 117a, 117b, 117c form circular along the outer peripheral face of stage portion 25.Contact 117d is made as circular along the inner peripheral surface of top end cover 116.

Contact 117d with after electric contact points (not shown) in the 2nd assembly 12 stated contact.The tubular element 202 (Figure 14) that is made up of conductive material in the 2nd assembly 12 is electrically connected with the tubular element that is made up of conductive material of insertion section 2b.Therefore, contact 117d is that the exhausting line that holding wire that the exhausting line when exporting with high frequency is used is connected is used contact.

Each contact is via conducting member 118 and the distribution 119 that is connected with this each conducting member, is connected with the corresponding distribution of distribution 2ab in the cable 2a, and this conducting member 118 passes in the top end cover 116 that is made up of insulating component.The conducting member 118 that passes in the top end cover 116 is arranged in the top end cover 116 through embedding molding.

Peripheral part at top end cover 116 is provided with O type ring 120.The housing 111 that top end cover 116 is installed is set to run through in the 2nd housing 121.The 2nd housing 121 is that diameter removes the cylindrical member that dwindles towards base end side from tip side.The inner peripheral surface fluid-tight engagement of O type ring 120 and the 2nd housing 121, the 1st housing 111 is configured in the 2nd housing 121 with top end cover 116.

In addition, on the outer peripheral face of the tip side of the 2nd housing 121, be formed with external thread part 121a.And, on the outer peripheral face of the base end side of the 2nd housing 121, also be formed with external thread part 121b.

The 2nd housing 121 also is arranged in the 3rd housing 122.The 3rd housing 122 also is that diameter removes the cylindrical member that dwindles towards base end side from tip side.On the outer peripheral face of the 3rd housing 122, be formed with a plurality of protuberance 122a of the controlling property that is used to improve operator.

Retainer ring 123 is fixed with the mode of clamping the 3rd housing 122 with end cap 124.Particularly, retainer ring 123 is the cylindrical members that are made up of the insulant member, has flange part inwardly in tip side.On the inner peripheral surface of the base end side of retainer ring 123, be formed with internal thread part 123a.End cap 124 is lid members of the tubular that is made up of insulating component, has stage portion at the peripheral part of tip side.On the inner peripheral surface of the tip side of end cap 124, be formed with internal thread part 124a.The external thread part 121a of the top ends through tightening the 2nd housing 121 and the internal thread part 123a of retainer ring 123; And tighten external thread part 121b and the internal thread part 124a of end cap 124 of the base end part of the 2nd housing 121, the 3rd housing 122 ring 123 that is fixed is fixed with the mode of clamping with end cap 124.

Carry out through as above that kind, ultrasonic oscillator unit 101 is configured in the handle part 22.

(heating countermeasure)

But, when the 1st assembly 11 is in the ultrasound wave output state, 101 heatings of ultrasonic oscillator unit.Its result, through successive ultrasound wave output, the heat that in ultrasonic oscillator unit 101, produces transmits in the housing of handle part 22, and the temperature of the peripheral part of handle part 22 is raise.In operation process, handle part 22 heating might cause the operability of handpiece 2 to reduce.

Therefore, in the 1st assembly 11 of this embodiment,, between the housing of handle part 22, be provided with air layer in order to prevent handle part 22 heating.

As shown in Figure 8, on the peripheral part of the 1st housing 111, be formed with axially extended a plurality of grooves 125 (125a, 125b, 125c) along housing 111.A groove 125a is used for and the 2nd housing 121 localized grooves, through making to the interior week of the 2nd housing 121 side-prominent part and groove 125a tabling, carries out the suitable location between the 1st housing 111 and the 2nd housing 121.Four groove 125b are used to the groove that supplies the conducting members 118 in the top end cover 116 to pass.Four groove 125c are the grooves that are used between the 1st housing 111 and the 2nd housing 121, forming air layer.

So,, can reduce the heat conduction between the housing, rise thereby can suppress handle part 22 temperature under successive ultrasound wave output through between the 1st housing 111 and the 2nd housing 121, air layer being set.

Particularly, like Fig. 4 and shown in Figure 5, the handle part 22 of the 1st assembly 11 uses three housings 111,121,122 and constitutes.Owing between the 1st housing 111 and the 2nd housing 121, be provided with as above such air layer that is provided with energetically, therefore can obtain bigger effect of heat insulation.And, owing between the 2nd housing 121 and the 3rd housing 122, also be formed with the air layer that forms by the gap, so effect of heat insulation further strengthens.

In addition, in this embodiment, used three housings, but also can use the housing more than four, and above-mentioned the sort of air layer has been set between adjacent housing energetically.

And; Because (being between the 1st housing 111 and the 2nd housing 121 in this embodiment) is provided with air layer between the housing of the inside of handle part 22; Covered by outermost housing (being the 3rd housing 122 in this embodiment); Therefore make under the situation of outermost housing 122 in molding, the degree of freedom that also can produce the outer shape of outermost housing 122 improves such effect.The degree of freedom of the outer shape through improving housing 122 can form the more excellent shape of controlling property that makes handle part 22.

In addition, above-mentioned probe 21 that kind as shown in Figure 4 are the cochlear shape, but also can be the hook shape of that kind shown in figure 10.Figure 10 is the cutaway view when to overlook top ends be the probe 21A of hook shape.The hook portion of probe 21A becomes the S word shape with the mode of the penetrating via 42 that can run through the 2nd assembly 12.It is edge part that the inboard of the hook shape portion of S word shape becomes the protuberance that cross sectional shape has predetermined angular.

In addition, each component parts of the 1st assembly 11 and the 2nd assembly 12 used with high pressure, high temperature vapor sterilization be that autoclave is handled pairing material, super engineering plastics etc. for example.But the 1st assembly 11 and the 2nd assembly 12 be so long as disposable type, and each component parts just also can be the parts of common resin material.

(connector portion 23 with connector portion 3a the structure that is connected)

Then, the structure that is connected of the connector portion 23 of the 1st assembly 11 being described and the connector portion 3a of agent set 3.

Figure 11 is the front view of the plug 151 in the connector portion 23.Figure 12 is the front view of the socket 161 in the connector portion 3a.Figure 13 be used to explain plug 151 and socket 161 be connected, along the profile of the XIII-XIII line of Figure 11 and Figure 12.

The connector portion 23 of the 1st assembly 11 has plug 151.Like Figure 11 and shown in Figure 13, plug 151 has central axis and is arranged on respect to the cylindrical portion 153 on the direction of the plane of base portion 152.And plug 151 has two protuberances of giving prominence to from base portion 152 154 and protuberance 155.The 1st protuberance 154 has and drives a plurality of lead-out terminal 154a that signal is used, and the 2nd protuberance 155 has a plurality of terminal 155a that switching signal and joint detection signal are used.Signal lines is connected among the holding wire 2ab in each of a plurality of terminal 154a, 155a and the cable 2a.The 1st protuberance 154 and the 2nd protuberance 155 are formed on the inboard of cylindrical portion 153.In addition, around cylindrical portion 153, be formed with a plurality of claw 153a, these a plurality of claw 153a match with the auxiliary section 163a (Figure 12) of the predetermined portions that is arranged on connector portion 3a respectively.

Connector portion 3a has socket 161.Like Figure 12 and shown in Figure 13, socket 161 has central axis and is arranged on respect to the cylindrical portion 163 on the direction of the plane of base portion 162.And socket 161 has the protuberance of giving prominence to from base portion 162 164.Protuberance 164 has two recesses 165,166.Two recesses 165,166 form towards base portion 162 from the tip side of protuberance 164.Protuberance 164 is formed on the inboard of cylindrical portion 163.On the interior perimembranous of cylindrical portion 163, be formed with a plurality of auxiliary section 163a that match with a plurality of claw 153a.

Have a plurality of lead-out terminal 165a that the driving signal is used on recess 165 its inner peripheral surface, have a plurality of terminal 166a that switching signal and joint detection signal are used on recess 166 its inner peripheral surface.Each terminal 165a, 166a are connected by the corresponding electrical circuits of signal lines with agent set 3.

In addition, on the protuberance 154 of plug 151, being formed with the cross section is the slot part 154b of semi-circular shape, make plug 151 with correct towards inserting socket 161.Slot part 154b forms the direction that is parallel to the plane of base portion 152.

On the other hand, on the interior perimembranous of the recess 165 of socket 161, be formed with the protuberance 165b of the semi-cylindrical form that cooperates with slot part 154b.Thereby, only the protuberance 165b of semi-cylindrical form be positioned at can with the situation of the position of the chimeric that kind of slot part 154b of plug 151 under, plug 151 with correct towards inserting socket 161, thereby can connector portion 23 be installed on the connector portion 3a.

In the 1st assembly 11, for example in plug 151, though not shown, the identification that is provided with the kind that is used to discern the 1st assembly 11 is with element resistor for example.Not shown resistor is connected with two terminal 155a that joint detection is used.If plug 151 is installed on the socket 161, then two terminal 155a are electrically connected with pairing two the terminal 166a of socket 161 sides, in agent set 3, can detect the connection of the 1st assembly 11 and the kind of the 1st assembly 11 that is connected.And, also can replace resistor and be provided with the distribution that connects between two terminal 155a that joint detection is used.In this case, agent set 3 can detect the connection of assembly or disconnected.

But, the 1st assembly 11 is being connected 3 last times of apparatus main body, the situation that exists plug 151 suitably not match sometimes with socket 161.For example be under the situation of the state that breaks away from from socket 161, possibly have the state that between the lead-out terminal that drives signal, forms the gap at plug 151.

In this state, for example, if operator is opened the switch of high frequency output, then the gap between the terminal used of the high frequency electric in plug 151 and socket 161 possibly produce electric spark.The generation of this electric spark can cause the damage or the fault of plug 151 and socket 161.

Therefore, in this embodiment, the configuration of the terminal in terminal in the plug 151 and the socket 161 is studied.

Shown in figure 13, when connector portion 23 was installed on the connector portion 3a, plug 151 moved along the installation direction shown in the arrow A A with respect to socket 161.A plurality of lead-out terminal 165a that a plurality of lead-out terminal 154a that driving signals in the plug 151 are used and the driving signal of socket 161 are used at first a plurality of terminal 166a of using of the interior switching signal of a plurality of terminal 155a of using of the switching signal in position contacting S1 and the plug 151 and joint detection signal and socket 161 and joint detection signal at first position contacting S2 on installation direction AA, stagger, promptly drive a plurality of terminal 165a that a plurality of lead-out terminal 154a that signal uses and switching signal and joint detection signal use and be configured on the peripheral part of protuberance 154,155 with the mode that has dislocation.

In Figure 13, a plurality of lead-out terminal 154a and a plurality of lead-out terminal 164a at first position contacting S1 than a plurality of terminal 155a and a plurality of terminal 165a at first position contacting S2 leave apart from d from base portion 152.Apart from d for example is 0.8mm.

Thus, when connector portion 23 was installed in connector portion 3a and goes up, after driving a plurality of lead-out terminal 154a that signal uses and a plurality of lead-out terminal 165a contact, a plurality of terminal 155a that switching signal and joint detection signal are used contacted with a plurality of terminal 166a.

As above-mentioned, the 1st assembly 11 has the plug 151 as the connector portion that is used for being connected with agent set 3, and agent set 3 has the socket 161 as the adapter that supplies plug 151 to connect.And; Be used to supply with the contact that drives signal and be configured in the position of staggering with respect to the contact that is used to transmit index signal along closure; So that along under the situation of predetermined closure connecting pin 151 and socket 161; Supply with after the contact that drives signals contacts each other to plug 151 being used for, the contact that is used to transmit index signal contacts each other, and this index signal is used to indicate the output that drives signal.

Therefore, even for example be under the situation of the state that breaks away from from socket 161, when in apparatus main body 3, detecting switching signal, also be bound between the lead-out terminal of high frequency electric be connected at plug 151.Its result when operator is opened the switch of high frequency output, can prevent to produce electric spark in the gap between the lead-out terminal that the driving signal in plug 151 and socket 161 uses.

(the 2nd assembly)

Specify the structure of the 2nd assembly 11.

Figure 14 is the cutaway view of the 2nd assembly 12.Three

electric contact point

201a, 201b, 201c are arranged on the inner peripheral surface of recess 41 of operating portion main body 32.Three

contact

201a, 201b, 201c be respectively with three contact 117a, 117b, the corresponding contact of 117c of the 1st assembly 11.When the 1st assembly 11 is installed in 12 last times of the 2nd assembly, three

contact

201a, 201b, 201c are to be arranged on the inner peripheral surface of recess 41 with three contact 117a, 117b, the contacted mode of 117c of the 1st assembly 11 respectively.

The tubular element 202 of the axis coaxle of central axis and insertion section 2b is arranged in the operating portion main body 23.Tubular element 202 is formed by conductive material.Base end side at tubular element 202 is formed with not shown notch part, and the 2nd assembly 12 constitutes, and runs through as if the base end side of the 1st assembly 11 from tubular element 202, and then stage portion 25 matches with recess 41.The inboard of the inboard of tubular element 202 and insertion section 2b forms penetrating via 42.

On the peripheral part of tubular element 202, be provided with spring member 203 across tubular element 204.Particularly, tubular element 202 runs through the tubular element 204 that is made up of insulant, and this tubular element 204 is through the inboard of spring member 203.On the peripheral part of tubular element 204, be formed with flange part 204a.The tip side of spring member 203 is born member 203a and flange part 204a connects across spring.But the base end side of spring member 203 connects with near the part of the pin 32a of fixed handle 35, but spring member 203 is arranged in the operating portion main body 32 with the mode that pushes fixed handle 35.Its result, but spring member 203 be with constant power to the direction that fixed handle 35 is left from fixed handle 34, in other words among Figure 14, be the constant force spring of the direction biasing handle 35 that is rotated counterclockwise of center with pin 32a.That is, the biasing member that spring member 203 is constructed as follows: but it is used for biasing fixed handle 35, but make that fixed handle 35 is that center of rotation is rotated to the open direction of handle portion 2c with pin 32a.

In addition, the top ends of tubular element 202 is electrically connected with insertion section 2b.Tubular element 202 forms when the 1st assembly 11 has combined with the 2nd assembly 12 with the contact 117d that on the surface of the stage portion 25 of the 1st assembly 11, exposes and is electrically connected.Thus, when the bipolar output of high frequency output, moveable jaws 31, insertion section 2b, tubular element 202, contact 117d, conducting member 118 and cable 2a constitute exhausting line.

Switch

36,37 is connected with contact 201c with contact 201b, common line with position via the circuit substrate 211 and the holding wire 212 of operating portion main body 32.Therefore, for example when high frequency was exported, as long as operator then was used to impel the switching signal from the 21 output high frequency outputs of popping one's head in to transmit to agent set 3 via contact 201b, 117b, conducting member 118 and cable 2a with thumb push switch 36.Therefore, as long as push switch 36, probe 21 will carry out high frequency output.In addition, as long as push switch 37, probe 21 will change the output valve of high frequency output.

(variation of the 2nd assembly)

Figure 15 is the front view of variation of the 2nd assembly of this embodiment.Above-mentioned handpiece 2 is used under the so-called peritoneoscope, but the 2nd assembly 12A shown in Figure 15 is the assembly of the handpiece used when being used to constitute laparotomy ventrotomy.The 2nd assembly 12A of this variation is included in that tip side has the cylindrical portion 251 in tapering, tube 252 and the axle that is arranged on the top ends of cylindrical portion 251 is bearing in the movable link 254 on the pin 253 of the peripheral part that is arranged at tube 252.

On the peripheral part of cylindrical portion 251, be provided with fixed handle 251b, what this fixed handle 251b had the finger lodge that supplies operator takes finger-hole 251a.The peristome 41A of the base end part of cylindrical portion 251 be used for from pop one's head in 21 insert the 1st assembly 11 opening.In Figure 15, shown in dotted line, the handling part 21a of the probe 21 of the 1st assembly 11 that inserts from cylindrical portion 251 is outstanding from the top ends of cylindrical portion 251.

But the base end side at movable link 254 is provided with fixed handle 254b, but should fixed handle 254b have the thumb lodge that supplies operator take finger-hole 254a.Tip side at movable link 254 is provided with moveable jaws 31A.

The same with above-mentioned the 2nd assembly 12, inner peripheral surface the 2nd assembly of the peristome 41A of the cylindrical portion 251 of the 2nd assembly 12A has and stage portion 25 corresponding shape and a plurality of electric contact point.Through insert the probe 21 of the 1st assembly 11 from peristome 41A, can the 1st assembly 11 be installed on the 2nd assembly 12A.Through the 1st assembly 11 is installed on the 2nd assembly 12A, and the handpiece 2A of the shears shape of using when constituting laparotomy ventrotomy.

Be installed under the state on the 2nd assembly 12A at the 1st assembly 11, operator can carry out the switching of the handling part that the handling part 21a by moveable jaws 31A and probe 21 top ends constitutes through operate mobile handle 254b.

In addition, in Fig. 2 and the 2nd assembly 12 shown in Figure 14, on operating portion main body 32, be provided with switch 36,37.Under the situation of the 2nd assembly 12A of Figure 15, two switches (not shown) corresponding with

switch

36,37 can be set on the peripheral part of the handle part 22 of the 1st assembly 11 also.

In addition; Consider operability; Shown in figure 16, but also can the 1st assembly the 2nd assembly will be arranged on position operating portion, be installed in the confession fixed handle 254b butt state on the 2nd assembly under at the 1st assembly of the 1st assembly 11 with the switch 36 pairing switches that are used for high frequency output.Promptly; Also can on handle part 22, be provided for sending at least one the switch of indication in output ultrasonic wave vibration and the high frequency electric, but this switch is configured in the position that the fixed handle that when the 2nd assembly 12B is installed, on handle part operating portion main body, can be configured the handle portion of the 2nd assembly 12 is pushed.

But Figure 16 is the figure that is used to explain the variation when being provided with switch in the position of the confession fixed handle butt of the 1st assembly.The 1st assembly 11A in the side of handle part 22, also be simultaneously but that the state that is being installed on the 2nd assembly 12B is provided with switch 36A in the position of fixed handle 254b the 2nd assembly closure time institute's butt down.Therefore, shown in figure 16, at the base end part of cylindrical portion 251A, be formed with notch part 251Aa in the part with the mode that exposes switch 36A.

Therefore, in the handpiece of when laparotomy ventrotomy, using, but because operator only carries out the output indication that the operation of closure fixed handle 254b just can be carried out high frequency output, so preferable operability.Particularly, but since the operation of only carrying out closure fixed handle 254b with a hands get final product, so need be, so the vertical handling part of handpiece can not rock with idle finger as not opening the operation that is used for the switch that high frequency exports.

In this case, switch 36A is preferably the two-stage switch.Figure 17 to Figure 19 is the figure of structure that is used to explain the switch 36A of the two-stage switch that is arranged on the 1st assembly.

Figure 17 and Figure 18 are the cutaway views that is used to explain the structure of switch 36A.Switch 36A is set on the surface of the housing 122 of handle part 22, be extruded with the pressing member 261 of conical shaped shape, and this pressing member 261 is made up of rubber component etc., and has smooth par 261a on the top.The dorsal part that in the inboard of pressing member 261 is par 261a is formed with protuberance 261b.Be provided with the hardware 261c of electric conductivity in the top ends of protuberance 261b.Hardware 261c is connected with not shown distribution.

Dispose substrate 262 in the inboard of housing 122.The position relative with protuberance 261b on substrate 262 is provided with the plectane member 263 that is made up of conductive metal material.Plectane member 263 is not smooth member, but has the shape of giving prominence to the direction of protuberance 261b along the surface curvature and the central part of spheroid.Plectane member 263 is connected with distribution 262a on the substrate 262, on the substrate below the plectane member 263 263, is provided with the contact 262b that is connected with not shown distribution.

Pressing member 261 is owing to be made up of rubber component etc., therefore if pushed then and can deform from the top.Shown in the dotted line of Figure 17, if pressing member 261 distortion, then the vertical hardware 261c of protuberance 261b contacts with plectane member 263.Through this contact, be connected in the distribution of hardware 261c and the distribution 262a of plectane member 263 and conduct, so agent set 3 can detect this conducting.If agent set 3 detects contacting of this hardware 261a and plectane member 263, then export the sound that is used to utilize this contact of sound notification operator (below, be called the 1st sound) by speaker.

If further push pressing member 261, then protuberance 261b further pushes plectane member 263,263 distortion of plectane member.Shown in figure 18, plectane member 263 distortion, the central part of plectane member 263 contacts with contact 262b on the substrate.Because contact 262b is connected with not shown distribution, therefore, is connected in the distribution of contact 262b and the distribution 262a of plectane member 263 and conducts through this contact.Therefore, agent set 3 detects this conducting, and output is used to notify the sound of this contact of operator by speaker with the 2nd sound different with the 1st sound, and begins to export high frequency electric.Output the 2nd sound during the central part of plectane member 263 and the contact 262b on the substrate are contacted.

In addition, if pressing member 261 is not pressed, then elastic component is that pressing member 261 recovers original shape such shown in the solid line of Figure 17, and plectane member 263 also recovers original shape such shown in the solid line of Figure 17.As above-mentioned, switch 36A is with the 1st grade of two-stage switch with the 2nd grade of output electric switch signal.

So, through using the two-stage switch as switch 36A, operator can go out the situation that the mode with close handles portion grips through the 1st voice recognition, and can go out the situation of high frequency output beginning through the 2nd voice recognition.In other words, agent set 3 utilizes the 1st sound notification and discerns the situation of gripping handle portion, can carry out high frequency output afterwards, so operator can carry out the operation of high frequency output reliably.

Figure 19 is the cutaway view of the variation of expression switch 36A.Switch shown in Figure 19 also is the two-stage switch, but the 1st grade is the switch that produces mechanical sounds.In addition, for the element identical, mark identical Reference numeral and omit explanation with Figure 17 and Figure 18.Shown in figure 19, switch 36Aa is set on the surface of the housing 122 of handle part 22 the outstanding pressing member 271 that is provided with the conical shaped shape, and this pressing member 271 is made up of thin metal etc., and has smooth par 271a on the top.The dorsal part that in the inboard of pressing member 271 is par 271a is formed with protuberance 271b.The side surface part 271c of pressing member 271 forms the shape that kind is heaved laterally a little shown in the solid line of Figure 19 when pressing member 271 is not pressed.

But side surface part 271c has following shape: along with pressing member 271 is pushed gradually from the top and is applied in distortional stress, shown in the dotted line among Figure 19 such at a time with suddenly to the inside the mode of depression be out of shape.When side surface part 271c short time set, produce mechanical sounds.

And if further push pressing member 271, then protuberance 271b pushes plectane member 263,263 distortion of plectane member, and as such shown in the with dashed lines among Figure 19,263 distortion of plectane member, the central part of plectane member 263 contacts with contact 262b on the substrate.Through this contact, be connected in the distribution of contact 262b and the distribution 262a of plectane member 263 and conduct, agent set 3 detects this conducting.Output is used to notify the sound of this contact of operator to agent set 3 by speaker, and begins to export high frequency electric.This sound of output during the central part of plectane member 263 and the contact 262b on the substrate are contacted.

In addition, if pressing member 261 is not pressed, then elastic component is that pressing member 271 recovers original shape such shown in the solid line of Figure 19, and plectane member 263 also returns to the original form.As stated, switch 36Aa utilizes the 1st grade of two-stage switch that produces mechanical sounds, utilizes the 2nd grade of output electric switch signal.

As above-mentioned, through using above-mentioned the sort of two-stage switch, operator can carry out the operation of high frequency output reliably.

(handling part)

The structure of handling part then, is described.

The handpiece 2 of this embodiment is output ultrasonic wave output simultaneously and high frequency output also.The handling part 21a of the probe 21 of cochlear shape has as the situation of ultrasound wave output, as the situation of high frequency output and the situation that is used as while output ultrasonic wave and high frequency.And probe 21 also has the situation that constitutes the handling part of shears shape with moveable jaws 31 through cooperation.This situation also has the handling part 21a of moveable jaws 31 and probe 21 as the situation of ultrasound wave output, as the situation of high frequency output and as the situation of output ultrasonic wave and high frequency simultaneously.Therefore, handling part 21a and jaw member 31 have the suitable shapes corresponding with this occupation mode.

Figure 20 is handling part 21a and jaw member 31 profile along the XX-XX line of Fig. 2.Jaw member 31 has the groove 311 that cooperates with the part of insertion section probe 21 vertically.This groove 311 with the cross section of the orthogonal axe of jaw member 31 on have the channel shape of opening broad.Though jaw member 31 is conductive materials, insulating component 312 is in bottom surface sections 313 upper edges of channel shape are axially disposed within the scope that supplies handling part 21a contact.

Handling part 21a with axial orthogonal cross section on have the local diamond shape that is cut.Shown in figure 20, the cross sectional shape of handling part 21a is along cutting the shape that forms with respect to the rhombohedral long orthogonal direction of diagonal.And in cross sectional shape, the handling part 21a that rhombohedral part is cut has the trapezoidal shape portion 321 that matches with the groove 311 of jaw member 31.In addition, in cross sectional shape, rhombohedrally do not cut the isosceles triangle portion 322 that partial part is the roughly isosceles triangle of handling part 21a.

In closure during handle portion 2c, handling part 21a and jaw member 31 tablings.When chimeric, the bottom surface sections 313 of the groove 311 of channel shape connects with the upper surface part 323 of the trapezoidal shape portion 321 of handling part 21a, and two inner wall parts 314 of the groove 311 of channel shape connect with the inclined plane part 324 of trapezoidal shape portion 321.

In addition, the top corner part 325 of the isosceles triangle portion 322 of handling part 21a forms and has fillet, but top corner part 325 has sharp keen a little angle.

When the 1st assembly 11 is used as the ultrasonic Treatment utensil of cochlear shape; Handling part 21a integral body plays a role as the ultrasonic vibration handling part, and particularly top corner part 325 and periphery thereof (dotting) play a role as scalpel for the tissue of process object.

In addition, when the 1st assembly 11 was used as the high-frequency treatment instrument of cochlear shape, the tissue that top corner part 325 and periphery thereof (dotting) are directed to process object played a role as electric mes.

When handpiece 2 was used as the ultrasonic Treatment utensil of shears shape, bottom surface sections 313 and inner wall part 314 and upper surface part 323 and inclined plane part 324 played a role as the acting surface of ultrasonic vibration.

In addition, when handpiece 2 was used as the high-frequency treatment instrument of shears shape, inner wall part 314 played a role with the acting surface of inclined plane part 324 as bipolar high frequency electric.

When the 1st assembly 11 be used as the cochlear shape, simultaneously during the preparation implement of output ultrasonic wave and high frequency; Handling part 21a integral body plays a role as the ultrasonic vibration handling part, and particularly top corner part 325 and periphery thereof (dotting) play a role as electric mes for the tissue of process object.

In addition; When handpiece 2 be used as the shears shape, simultaneously during the preparation implement of output ultrasonic wave and high frequency; Bottom surface sections 313 plays a role with the acting surface of upper surface part 323 as ultrasonic vibration, and inner wall part 314 plays a role with the acting surface of inclined plane part 324 as bipolar high frequency electric.

Thereby; Adopt the structure of handling part shown in Figure 20; Not only with the 1st assembly 11 as the situation of ultrasonic Treatment utensil or high-frequency treatment instrument under preferable operability, and linking the 1st assembly 11 with the 2nd assembly 12 and under and to link under the 1st assembly 11 is used as the preparation implement shears shape, when while output ultrasonic wave and high frequency with the 2nd assembly 12 the situation operability also better as the situation of the ultrasonic Treatment utensil of shears shape or high-frequency treatment instrument.

In addition, also can be made as, the surgical instrument of the shears shape of the 1st assembly and the 2nd assembly be combined into is carrying out high frequency when output or is carrying out high frequency and can carry out one pole output when exporting simultaneously but not bipolar output is used as high frequency exports with hyperacoustic.

Figure 21 is the figure that is used to explain the structure of the handling part under the situation of probe 21A of hook shape.Particularly, Figure 21 is handling part 21Aa and the jaw member 31A profile along the XXI-XXI line among Figure 10.Figure 10 only shows handling part 21Aa, but in Figure 21, shows handling part 21Aa and the section of jaw member 31A under the situation of preparation implement of shears shape.Jaw member 31A has the groove 311A that cooperates with the part of handling part 21Aa vertically.This groove 311A with the cross section of the orthogonal axe of jaw member 31A on have the channel shape of opening broad.Jaw member 31A is a conductive material, but insulating component 312A is arranged on the bottom surface sections 313A of channel shape vertically.

Handling part 21Aa with axial orthogonal cross section on have the local diamond shape that is cut.Shown in figure 21, the cross sectional shape of handling part 21Aa is that the edge has cut the shape that a rhombohedral part forms with a rhombohedral orthogonal direction of diagonal.And in cross sectional shape, the handling part 21Aa that rhombohedral part is cut has the 321A of trapezoidal shape portion that matches with the groove 311A of jaw member 31A.In cross sectional shape, rhombohedral by do not cut partial part be the probe 21A the 322A of isosceles triangle portion.

In closure during handle portion 2c, handling part 21Aa and jaw member 31A tabling.When chimeric, the upper surface part 323A of the 321A of trapezoidal shape portion of the bottom surface sections 313A of the groove 311A of channel shape and handling part 21Aa connects, and two the inner wall part 314A of the groove 311A of channel shape and the inclined plane part 324A of the 321A of trapezoidal shape portion connect.

In addition, the top corner part 325A of the 322A of isosceles triangle portion of handling part 21Aa forms and has fillet, but the top corner part 326 of the inboard of hook shape has sharp keen a little angle.The angle θ of top corner part 326 is preferably 45 degree to 100 degree.45 degree are intensity boundaries of probe 21A.As above-mentioned, the protuberance that the inboard that the top corner part 326 of handling part 21Aa is formed in hook shape portion has predetermined angular is an edge part.

The handling part of hook shape is used for cutting more.The top corner part 326 of probe 21A becomes the agency part when cutting.Because top corner part 326 has sharp keen a little angle θ, in cutting processing, be effective therefore.

Handling part 21Aa shown in Figure 21 with jaw member 31A the effect during except above-mentioned incision respectively when ultrasound wave is exported, the identical effect of performance and handling part 21a shown in Figure 20 and jaw member 31 during output during high frequency output and in ultrasound wave and the high frequency.

(structure of apparatus main body)

Then, the control part of the output that is used to control above-mentioned handpiece 2 being described is the structure of agent set 3.Figure 22 is the block diagram of the structure of expression agent set 3.Agent set 3 is the control parts that are used to control the output that drives signal, and this drivings signal is used at least one of the 1st assembly 11 supply ultrasonic vibrations and high frequency electric.

Shown in figure 22, agent set 3 comprises ultrasound wave output control part 51, high frequency output control part 61 and switch control portion 71.Ultrasound wave output control part 51 comprises that control circuit 52 and output are used for the output circuit 53 of the driving signal of ultrasonic vibration.High frequency output control part 61 comprises that control circuit 62 and output are used for the output circuit 63 of the driving signal of high frequency electric output.Control circuit 52 and control circuit 62 are made up of various circuit such as CPU, memorizeies.

Control circuit 52 is connected with action button 3c with the display 3b of agent set 3 with control circuit 62.Operation signal HS from the

switch

36,37 of the operation signal FS of foot switch 4 and handpiece 2 is input in control circuit 52 and the control circuit 62.Connect signal DS to switch control portion 71 inputs.Switch control portion 71 is supplied with the output control signal according to connecting signal DS to control circuit 52 and control circuit 62.As above-mentioned, be connected 11 last times of the 1st assembly at the 2nd assembly 12, contact 117a is connected with contact 201a.Through this contact, it is that the 2nd assembly 12 has been connected the situation on the 1st assembly 11 that agent set 3 can detect connection signal DS by holding wire 2ab.Therefore, contact 117a constitutes with holding wire 2ab can export the connection signal efferent that is connected signal DS, and this connection signal DS representes that the 2nd assembly 12 has been connected the situation on the 1st assembly 11.

Output circuit 53 is supplied with the driving signal DR1 that is used for ultrasonic vibration to the 1st assembly 1.Output circuit 63 is supplied with the driving signal DR2 that is used for high frequency electric output to the 1st assembly 1.Control circuit 52 and control circuit 62 are respectively according to the setting among the action button 3c and from the operation signal of foot switch 4 and switch 36,37; Output circuit 53 and output circuit 63 are supplied with output control signal CS1, CS2, and output circuit 53 is exported control signal CS1 and output control signal CS2 output drive signal DR1, DR2 according to this respectively with output circuit 63.

Agent set 3 is exported the driving signal of exporting when being used to carry out ultrasound wave output, high frequency output or ultrasound wave and high frequency according to above-mentioned setting and operation signal to handpiece 2 or the 1st assembly 11.

As stated, under the situation that only is connected with the 1st assembly 11, these three patterns of output mode when agent set 3 has ultrasound wave output mode, high frequency output mode and ultrasound wave and high frequency.In addition; The 1st assembly 11 is being installed under the situation of the handpiece 2 that forms on the 2nd assembly 12 these three patterns of output mode when agent set 3 has the high frequency of high frequency output mode and ultrasound wave and bipolar output (perhaps also can be one pole output) of ultrasound wave output mode, bipolar output.

And agent set 3 is according to connecting the output that signal DS control drives signal, and this drivings signal is used at least one of the 1st assembly 11 supply ultrasonic vibrations and high frequency electric.

That is, for example in operation process, to detect the handling part that the 1st assembly 11 is connected the 2nd assembly be the situation on the recess 41 if agent set 3 is according to connecting signal DS; Then when the output high frequency electric; Control drives the output of signal DR2, switching to bipolar output (perhaps one pole output), and when output ultrasonic wave vibrates; Control drives the output of signal DR1, drives output to switch to the ultrasound wave that is suitable for the processing under the shears shape handling part.

And; If agent set 3 detects the situation that the 1st assembly 11 unloads from the recess 41 of the 2nd assembly according to connecting signal DS, then when the output high frequency electric, control drives the output of signal DR2; To switch to one pole output; And when output ultrasonic wave vibrated, control drove the output of signal DR1, drove output to switch to the ultrasound wave that is suitable for the processing under the cochlear shape handling part.

In addition; Likewise; If agent set 3 detects the 1st assembly 11 and is connected the situation on the recess 41 of the 2nd assembly according to connecting signal DS; When then output ultrasonic wave vibration was with high frequency electric at the same time, control drove the output of signal DR1, DR2, exported when switching to the high frequency electric processing that is suitable for shears shape handling part under, ultrasonic vibration and bipolar output (perhaps one pole output).

And; If agent set 3 detects the situation that the 1st assembly 11 unloads from the recess 41 of the 2nd assembly according to connecting signal DS; Then control drives the output of signal DR1, DR2, with the above-mentioned high frequency electric output that switches to above-mentioned ultrasonic vibration output that the ultrasound wave that is suitable for the processing cochlear shape handling part under drives output, one pole output, or export when being suitable for the ultrasonic vibration of the processing cochlear shape handling part under and high frequency electric that one pole is exported.

As above-mentioned, agent set 3 can automatically be controlled the output that drives signal according to connecting signal DS, and this drivings signal is used at least one of the 1st assembly 11 supply ultrasonic vibrations and high frequency electric.

In addition; In the above-described embodiment; According to connecting signal DS, the change of the output valve of for example bipolar and unipolar change of the change that agent set 3 is automatically exported or ultrasound wave output etc. predetermined lamp such as light but also can be made as according to connection signal DS; The switching that the connection state of notice operator the 1st assembly 11 and the 2nd assembly 12, operator utilize the action button of agent set 3 etc. to export.

And; The handpiece 2 of above-mentioned embodiment can be distinguished or export high frequency output simultaneously and export the two with ultrasound wave, but the output switching controls of this embodiment also can be applied to only can carry out the handpiece of high frequency output or the handpiece that only can carry out ultrasound wave output.For example; Under the situation of the handpiece that only can carry out high frequency output; Agent set 3 switches output according to connecting signal DS, makes under the situation that is merely the 1st assembly, high frequency output to be made as one pole output, then high frequency output is made as bipolar output if the 1st assembly is attached on the 2nd assembly.In addition; Under the situation of the handpiece that only can carry out ultrasound wave output; Agent set 3 switches output according to connecting signal DS; Make under the situation that is merely the 1st assembly and to carry out ultrasound wave output, carry out ultrasound wave output if the 1st assembly is attached on the 2nd assembly then with the 2nd setting value of the handling part that is suitable for the shears shape with the 1st setting value of the handling part that is suitable for the cochlear shape.

As above-mentioned; Adopt above-mentioned embodiment, can realize following medical treatment device and surgical instrument: in a preparation implement, can easily change surgical instrument and the surgical instrument that the type of bio-tissue is handled in contact that the type of bio-tissue is handled in clamping.

The replacing time of preparation implement is short more good more in the operation process, and this is because alleviate the burden to the patient.In the past, operator preparation implement from this moment to nurse that wait and send indication, will use was always passed nurse etc., nurse etc. and is carried out unloading from control device operation such as preparation implement, passs this above-mentioned a succession of operation of preparation implement that next operator use and have not only complicacy but also the such problem of spended time.

In addition, the high-frequency treatment instrument tool that proposed of above-mentioned TOHKEMY 2009-78155 communique is the pliers of the structure of top ends with member in two members of the bipolar pliers elongated portion that is provided with unipolar component.Adopt this high-frequency treatment instrument, operator need not to prepare in advance respectively one pole preparation implement and bipolar preparation implement, just can utilize a preparation implement to carry out the processing of one pole output and bipolar output.

But; The high-frequency treatment instrument of this motion is used for owing to the top ends at bipolar pliers has and can extends the structure of unipolar component on the member at two members, so exists the size and the shape of a member maximization and complicated and unipolar component to be restricted such problem.The restriction of size of the maximization of top ends, complicated and unipolar component etc. causes operator to feel the ease of use variation of preparation implement; In addition; Because the restriction of the maximization of top ends and the size of unipolar component etc., under peritoneoscope, the visual field of operator is possible deviation also.

To this; Adopt the embodiment of the invention described above, can realize following medical treatment device and surgical instrument: in a preparation implement, can easily change surgical instrument and the surgical instrument that the type of bio-tissue is handled in contact that the type of bio-tissue is handled in clamping.

The present invention is not limited to above-mentioned embodiment, in the scope that does not break away from purport of the present invention, can carry out various changes, change etc.

The application requires the basis of priority No. 61/319386 and the application that proposes with the temporary patent application that on March 31st, 2010 proposed in the U.S., and above-mentioned disclosure is incorporated in the application's the description, claims.

Claims

1. a medical treatment device is characterized in that, comprise the 1st assembly, the 2nd assembly, connect signal efferent and control part,

Above-mentioned the 1st assembly comprises: handle part; Probe, it is connected with this handle part, and can transmit in ultrasonic vibration and the high frequency electric at least one; And the 1st handling part, it is arranged on the top ends of above-mentioned probe, and at least one of above-mentioned ultrasonic vibration that is used for being transmitted by above-mentioned probe to the bio-tissue transmission and high frequency electric;

Above-mentioned the 2nd assembly comprises: the 2nd handling part, and it is used for clamping bio-tissue between the 2nd handling part and above-mentioned the 1st handling part; But fixed handle, it is used to make above-mentioned the 2nd handling part to come the above-mentioned bio-tissue of clamping near above-mentioned the 1st handling part; And the handling part, it is used for cooperating with above-mentioned the 1st assembly with the mode that can load and unload freely;

Above-mentioned connection signal efferent is used for output and connects signal, and this connection signal indication is connected with above-mentioned the 1st assembly on the above-mentioned handling part of above-mentioned the 2nd assembly,

Above-mentioned control part is used to control the output that drives signal, and this driving signal is used for supplying with at least one of above-mentioned ultrasonic vibration and high frequency electric to above-mentioned the 1st assembly.

2. medical treatment device according to claim 1 is characterized in that,

Above-mentioned control part is according to controlling the output that drives signal from the above-mentioned connection signal of above-mentioned connection signal control part, this driving signal is used for supplying with at least one of above-mentioned ultrasonic vibration and high frequency electric to above-mentioned the 1st assembly.

3. medical treatment device according to claim 2 is characterized in that,

In the time of when go out the above-mentioned handling part that above-mentioned the 1st assembly is connected above-mentioned the 2nd assembly according to above-mentioned connection signal detection on; Above-mentioned control part is controlled the output of above-mentioned driving signal; Make and switch to bipolar output during above-mentioned high frequency electric in output, switch to the 1st ultrasound wave during in the above-mentioned ultrasonic vibration of output and drive output

And; When going out above-mentioned the 1st assembly according to above-mentioned connection signal detection from situation that the above-mentioned handling part of above-mentioned the 2nd assembly is unloaded; Above-mentioned control part is controlled the output of above-mentioned driving signal, makes that when the above-mentioned high frequency electric of output, switching to one pole exports, when the above-mentioned ultrasonic vibration of output, switches to the 2nd ultrasound wave driving output.

4. medical treatment device according to claim 2 is characterized in that,

In the time of when go out the above-mentioned handling part that above-mentioned the 1st assembly is connected above-mentioned the 2nd assembly according to above-mentioned connection signal detection on; Above-mentioned control part is controlled the output of above-mentioned driving signal; Make output when switch to the 1st ultrasound wave drives the above-mentioned high frequency electric of above-mentioned ultrasonic vibration and bipolar output of output

And; When going out above-mentioned the 1st assembly according to above-mentioned connection signal detection from situation that the above-mentioned handling part of above-mentioned the 2nd assembly is unloaded; Above-mentioned control part is controlled the output of above-mentioned driving signal, make the above-mentioned high frequency electric output switch to above-mentioned ultrasonic vibration output that above-mentioned the 1st ultrasound wave drives output, one pole output, or export the above-mentioned high frequency electric of the 1st ultrasound wave above-mentioned ultrasonic vibration that drives output and one pole output the time.

5. medical treatment device according to claim 1 is characterized in that,

Above-mentioned connection signal efferent be be connected above-mentioned the 2nd assembly on the holding wire that is connected of contact.

6. medical treatment device according to claim 1 is characterized in that,

Above-mentioned the 2nd handling part constitutes the exhausting line of above-mentioned high frequency electric.

7. according to each described medical treatment device in the claim 1 to 6, it is characterized in that,

Above-mentioned the 1st handling part has the cochlear shape,

Above-mentioned the 1st handling part with the cross section of the direction of the orthogonal axe of above-mentioned probe on, have roughly isosceles triangle shape in a side opposite with above-mentioned the 2nd handling part.

8. according to each described medical treatment device in the claim 1 to 6, it is characterized in that,

Above-mentioned the 1st handling part has hook shape,

Above-mentioned the 1st handling part with the cross section of the direction of the orthogonal axe of above-mentioned probe on, have a protuberance of predetermined angular in the inboard of above-mentioned hook shape.

9. medical treatment device according to claim 8 is characterized in that,

Above-mentioned predetermined angular is the scope of 45 degree to 100 degree.

10. a surgical instrument is characterized in that, comprising:

Handle part;

Probe, it is connected with this handle part, and can transmit in ultrasonic vibration and the high frequency electric at least one; And

The 1st handling part, it is arranged on the top ends of this probe, and at least one of above-mentioned ultrasonic vibration that is used for being transmitted by above-mentioned probe to the bio-tissue transmission and high frequency electric;

Above-mentioned surgical instrument has can export the connection signal efferent that connects signal; This connection signal indication is connected with the situation of the device with the 2nd handling part on being installed in above-mentioned surgical instrument the time, and the 2nd into treatment sites is in the position relative with the top ends of above-mentioned probe.

11. surgical instrument according to claim 10 is characterized in that,

Above-mentioned connection signal efferent be be connected said modules on the holding wire that is connected of contact.

12. surgical instrument according to claim 10 is characterized in that,

Above-mentioned surgical instrument has the insulating sheath of the part except that above-mentioned the 1st handling part that covers above-mentioned probe.

13. surgical instrument according to claim 10 is characterized in that,

Above-mentioned the 1st handling part has the cochlear shape,

14. surgical instrument according to claim 10 is characterized in that,

Above-mentioned the 1st handling part has hook shape,

15. surgical instrument according to claim 10 is characterized in that,

Above-mentioned handle part has at least one the switch of indication that is used for sending above-mentioned ultrasonic vibration of output and high frequency electric.